Sequential CD19 and CD22 CAR-T Therapy for Newly Diagnosed Ph+ B-ALL

This study was designed as a prospective, open-label, single-center study. It aims to evaluate the efficacy and safety of CD19 CAR-T cells in combination with dasatinib for the treatment of newly diagnosed Ph-positive B-cell acute lymphoblastic leukemia in adult.

Inclusion criteria

• Age ≥ 18 years old;
• Subjects with a diagnosis of B-cell acute lymphoblastic leukemia according to the 2016 edition of the WHO classification criteria for acute leukemia;
• Subjects whose chromosomal and fusion gene analysis showed positivity for the Ph chromosome, BCR/ABL1 fusion gene;
• Leukemia cells were CD19 and CD22 positive;
• Patients with newly diagnosed B-ALL were not treated with standard chemotherapy regimens;
• Serum total bilirubin ≤ 51 mol/L, serum ALT and AST both ≤ 3 times the upper limit of the normal range, blood creatinine ≤ 176.8 mol/L;
• Echocardiography showed a left ventricular ejection fraction (LVEF) ≥50%;
• Subjects had no active pulmonary infection and oxygen saturation ≥92% without oxygen;
• The prognosis for survival is more than 3 months;
• ECOG score 0-2;
• Subjects volunteered to participate in this trial and signed an informed consent form.

Exclusion criteria

Subjects with any of the following exclusion criteria were not eligible for enrollment in this trial:

• Those with a history of epilepsy or other central nervous system disorders;
• Those with a history of prolonged QT period or severe cardiac disease;
• Women who are pregnant or breastfeeding (the safety of this therapy for the unborn child is not known);
• Those with uncontrolled active infection;
• Active hepatitis B or hepatitis C virus infection;
• Those who have previously used any gene therapy product;
• Those with insufficient amplification (<5-fold) in response to CD3/CD28 co-stimulatory signals;
• Creatinine > 2.5 mg/dl or ALT / AST > 3 times the upper limit of the normal range or bilirubin > 2.0 mg/dl;
• Those who suffer from other uncontrolled medical conditions that, in the opinion of the investigator, make them unsuitable for enrollment;
• HIV-infected persons;
• Any condition that, in the opinion of the investigator, may increase the risk to the subject or interfere with the results of the test.